NPIMap

Organization Active NPI

Generations Family Practice, PA

  • Specialist
  • Jacksonville, NC
National Provider Identifier
1013674332
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
GENERATIONS FAMILY PRACTICE, PA
Practice address
158 Memorial CT
Jacksonville, NC 28546-6322
Phone
(910) 353-5111
Fax
(910) 353-2849
NPI assigned
Nov 22, 2021
Organization subpart
Yes
Parent organization
GENERATIONS FAMILY PRACTICE, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ashley Renee Long
Title
Practice Implementation Manager
Phone
(984) 333-2741

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X

Addresses

Primary practice location

158 Memorial CT
Jacksonville, NC 28546-6322

Mailing address

1021 Darrington Dr Ste 101
Cary, NC 27513-8158
Phone (984) 333-2741

Other names 1

  • Andre KS Tse MD Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060425000762 NC Part B Supplier - Clinic/Group Practice 7517977200 Receives reassigned benefits from 76 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Asheboro, NC; Carrboro, NC; Cary, NC; Greensboro, NC; Kernersville, NC; Rocky Mount, NC; Wendell, NC

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Rocky Mount Family Medical Center PA

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637539200000",
    "number": "1013674332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 DARRINGTON DR STE 101",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275138158",
            "telephone_number": "984-333-2741",
            "fax_number": "919-378-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 MEMORIAL CT",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466322",
            "telephone_number": "910-353-5111",
            "fax_number": "910-353-2849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENERATIONS FAMILY PRACTICE, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GENERATIONS FAMILY PRACTICE, PA",
        "enumeration_date": "2021-11-22",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-04",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "PRACTICE IMPLEMENTATION MANAGER",
        "authorized_official_telephone_number": "984-333-2741"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Andre KS Tse MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.